Separation Anxiety Disorder

What is the diagnostic criteria?

excessive fear or anxiety about separation from attachment figures evidenced by at least three:

distress when anticipating or experiencing separation from home or major attachment figures

worry about losing attachment figures for about possible harm to them

worry about experiencing an even that causes separation from attachment figure

reluctance or refusal to go out, away from home because of fear of separation

physical symptoms when separation is anticipated or occurs:

headaches

nausea

vomitting

persistent at least 4 weeks in children/adolescents, typically 6+ months in adults

causes significant distress or impairment

What are some specific aspects of this disorder?

• may exhibit a lifelong course with onset in childhood BUT many adults do not recall a childhood onset

• in children often associated with parents who do not let the child engage in basic activities

• younger children may demonstrate less credible fears, older children and adolescents may have more credible fears

What are the manifestations of separation anxiety?

• worrying that harm or some other untoward event (ex. kidnapping) will lead to separation

• refusal to go to work/school

• reluctance or refusal to go to sleep without being near the attachment figure

• nightmares

• physical symptoms on occasions that involve separation from the attachment figure

Is this disorder common?

It is one of the most common anxiety disorders in young children.

What is the onset?

Typically in childhood, onset during adolescence/adulthood is less common

What is the comorbidity?

• in children/adolescents: generalized anxiety disorder, specific phobia, ADHD

• in adults: mood and anxiety disorders, PTSD, personality disorders

What are the gender differences?

Lifelong. slightly more common among women than men, no differences in school refusal in children.